Publications by authors named "Josep Balana"

Kidney stones are becoming increasingly common, affecting up to 10% of adults. A small percentage are of monogenic origin, such as Dent's disease (DD). DD is a syndrome that causes low-molecular-weight proteinuria, hypercalciuria, nephrolithiasis, and nephrocalcinosis.

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Context: Thulium fiber laser (TFL) emerged as a competitor of holmium:yttrium aluminum garnet (Ho:YAG) laser for the treatment of urinary stones.

Objective: To compare the efficacy between Ho:YAG and TFL for laser lithotripsy of renal and ureteral stones.

Evidence Acquisition: A literature search was conducted using PubMed/Medline, Embase, and Web of Science databases to identify reports published until May 2023.

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The aim of the study was to compare standard high-power laser (with < 80 Hz) to extended frequency (> 100 Hz) lithotripsy during miniPCNL. 40 patients were randomized in to two groups undergoing MiniPCNL. For both groups, the Holmium Pulse laser Moses 2.

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(1) Background: New pulse modulation (PM) technologies in Holmium:YAG lasers are available for urinary stone treatment, but little is known about them. We aim to systematically evaluate the published evidence in terms of their lithotripsy performance. (2) Methods: A systematic electronic search was performed (MEDLINE, Scopus, and Cochrane databases).

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Introduction & Objectives: Radiation-induced haemorrhagic cystitis (RHC) is a frightening complication occurring after pelvic radiotherapy (PRT) which may significantly affect patients' quality of life. Bladder instillation with glycosaminoglycan replacement therapy (GRT) including hyaluronic acid +/- chondroitin sulphate has been proposed as an emerging alternative to prevent relapses of haematuria. Strong points in favour of using GRT for RHC are the ease of administration, cost, almost absence of side effects and possibility of administration to outpatients.

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Objective: To assess whether bacillus Calmette-Guérin (BCG) responsiveness after initiation of an adequate BCG treatment (at least five of six instillations of induction and at least two of three instillations of maintenance) impacts oncological outcomes in patients with carcinoma in situ (CIS) of the bladder treated with BCG immunotherapy.

Patients And Methods: Data were available for 193 patients with bladder CIS with or without associated cTa/cT1 disease who received an adequate BCG treatment between 2008 and 2015. Bladder biopsies were taken at 6 months and patients were then stratified as either BCG responsive (negative biopsies) or BCG unresponsive (positive biopsies).

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Article Synopsis
  • Encrusted uropathy (EU) is a rare and increasingly common condition caused by bacteria that break down urea, leading to the formation of urinary calcifications.
  • Treatment typically involves antibiotics, urinary diversion techniques, and in some cases, surgery, but a case study shows that oral l-methionine can effectively manage urinary encrustations with minimal side effects.
  • After 12 months of treatment with oral l-methionine, significant improvements were noted, allowing for the successful removal of remaining calcifications through less invasive surgical procedures.
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Article Synopsis
  • The study aimed to evaluate how accurately ureteroscopic (URS) biopsies can predict the stage and grade of upper tract urothelial carcinoma (UTUC) based on final pathology results.
  • The results from 23 studies involving 3547 patients show that while high-grade tumors have a high predictive value (97%) in URS biopsies, there are significant rates of undergrading (32%) and understaging (46%) for low-grade and non-muscle-invasive diseases.
  • The research concludes that while URS biopsies can be fairly reliable for identifying high-grade tumors and invasive disease, there is a notable risk for misclassification, which should be considered in clinical assessments.
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Objectives: Confocal lasser endomicroscopy (CLE) is an optical technique that enables in vivo cytological characterization of a tissue. Previous studies have shown it useful in the evaluation of urinary and respiratory tracts for a better characterization of mucosal lesions, showing a high concordance between in vivo and final histopathological results. Recently, the use of CLE has been proposed for the study of transitional cell carcinoma of the upper urinary tract (UUT) during ureteroscopy, because it enables real time information about tumor grade and supplements the information of ureteroscopic biopsies, which may understimate the grade and stage of the lesion up to 43% of the cases due to its limitiations.

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Objective: Renal cryotherapy (RC) is an alternative therapeutic option to partial nephrectomy in elderly patients and/or patients with comorbidities. The technique can be guided by ultrasound, CT and MRI. Although CT is the most used technique, there are no comparative studies.

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The first-line treatment in cases of chylous leakage is conservative, and operation should be considered only in patients who fail to respond to this treatment. The main clinical concern is the difficulty of intraoperative localization of the site of leakage that can affect surgical outcome. A 33-year-old man presented with a 4-month history of abdominal pain and weight loss.

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